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Incisor irregularity and dental arch dimensions changes in subjects with different severity of anterior crowding: a 37-year follow-up. 不同前牙拥挤程度受试者的切牙不规则和牙弓尺寸变化:37年随访。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-03-20 DOI: 10.1186/s40510-023-00461-8
Caroline Martins Gambardela-Tkacz, Gabriela Alcaraz, Paula Cotrin, Karina Maria Salvatore de Freitas, Willana Moura, Guilherme Janson, Daniela Garib, Marcos Roberto de Freitas

Background: Occlusal stability is one of the goals of orthodontic treatment, and keeping teeth aligned in the long term is a challenge for the orthodontist. This study aimed to compare the long-term incisors irregularity and dental arches dimensions changes in subjects treated with 4 premolar extractions with different pretreatment Little's irregularity index (LII). The knowledge of long-term outcomes is evidence-based information for the prognosis of future treatments.

Methods: In total, 41 treated subjects were divided into two groups according to mandibular Little irregularity value at pretreatment (mild or severe). The maxillary and mandibular LII, transversal, and longitudinal widths were assessed at pretreatment, posttreatment, and 37-year posttreatment. Chi-square and independent t tests were used for intergroup comparison.

Results: The groups presented similar behavior for all stages of maxillary and mandibular arch dimensions changes. Maxillary irregularity was corrected in both groups after treatment, and the alignment was acceptable in the long term. In the mild group, the mandibular incisor irregularity returned to pretreatment values in the long term. The mandibular LII increased in the severe group but did not return to pretreatment values in the long term.

Conclusions: The mild crowding group presented proportionally more relapse of mandibular incisor irregularity than the severe crowding group in the long term. Even so, the correction of mild and severe crowding with the extraction of 4 premolars showed satisfactory results in the long term, even with the presence of maturational changes and relapse.

背景:咬合稳定是正畸治疗的目标之一,长期保持牙齿排列对正畸医师来说是一个挑战。本研究旨在比较4种前磨牙拔牙后不同预处理方式的小不规则指数(LII)的长期门牙不规则度和牙弓尺寸的变化。对长期结果的了解是未来治疗预后的循证信息。方法:按预处理时下颌小不规则值(轻度和重度)分为两组,共41例。在治疗前、治疗后和治疗后37年评估上颌和下颌的LII、横向和纵向宽度。组间比较采用卡方检验和独立t检验。结果:两组在上颌弓和下颌骨各阶段的尺寸变化表现相似。治疗后两组上颌畸形均得到矫正,长期矫正效果良好。在轻度组,下颚切牙不平整恢复到长期的预处理值。重度组下颌骨LII升高,但长期未恢复到预处理值。结论:长期来看,轻度拥挤组下切牙畸形复发率高于重度拥挤组。尽管如此,通过拔除4颗前磨牙对轻度和重度拥挤的矫正,即使存在成熟的变化和复发,长期来看也取得了令人满意的效果。
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引用次数: 1
Effects of IPR by mechanical oscillating strips system on biological structures: a quantitative and qualitative evaluation. 机械振荡条带系统IPR对生物结构的影响:定量和定性评价。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-03-13 DOI: 10.1186/s40510-023-00460-9
Francesca Gazzani, Denise Bellisario, Laura Fazi, Alessia Balboni, Silvia Licoccia, Chiara Pavoni, Paola Cozza, Roberta Lione

Background: To evaluate by means of profilometric analysis and scanning electronic microscope (SEM) the effects on enamel surfaces of oscillating mechanical systems for interproximal enamel reduction (IPR). Fifteen complete (Group 1) oscillating IPR sequence and 15 single metallic strips (Group 2) for active IPR phase of 0.2 mm were selected and tested on 30 freshly extracted teeth by means of tribological tests with alternative dry-sliding motion (Linear Reciprocating Tribometer, C.S.M. Instruments, Peseaux, Switzerland). Enamel surface roughness and waviness measurements were assessed by contact probe surface profiler (TalySurf CLI 2000; Taylor Hobson, Leicester, UK) and a TayMap software for the 3D analysis. Statistical analysis was performed with independent samples t-test. Significance was established at the P < .05 level. SEM analysis of enamel surfaces was conducted with a FEI Quanta 200 (Hillsboro, USA) in high vacuum at 30.00 kV. Images were acquired at 30X, 100X, and 300X of magnification.

Results: Teeth undergone Group 1 showed lower values of surface roughness (Ra - 0.34 µm, Rt - 1.55 µm) and significant increase of waviness parameters (Wa 0.25 µm, Wt 4.02 µm) when compared with those treated with Group 2. SEM evaluation showed smoothers and more regular surfaces when IPR was performed by complete IPR sequence. Single metallic strip determined more irregular surfaces characterized by extended grooves, alternated with enamel ridges and irregular fragments.

Conclusion: The adoption of a standardized oscillating IPR sequence determines more regular and harmonious enamel surfaces at the end of the procedure. An adequate polishing after IPR plays a crucial role to guarantee a good long-term prognosis and a good respect of biological structures.

背景:采用轮廓分析和扫描电镜(SEM)评价振荡机械系统对近端间牙釉质复位(IPR)牙釉质表面的影响。选择15个完整的(第1组)振荡IPR序列和15个0.2 mm主动IPR相位的单金属条(第2组),通过可选干滑动运动的摩擦学测试在30个刚拔出的牙齿上进行测试(Linear往复Tribometer, C.S.M. Instruments, Peseaux, Switzerland)。牙釉质表面粗糙度和波纹度测量采用接触探针表面轮廓仪(TalySurf CLI 2000;Taylor Hobson, Leicester, UK)和用于3D分析的TayMap软件。采用独立样本t检验进行统计学分析。结果:与组2相比,组1的牙齿表面粗糙度值较低(Ra - 0.34µm, Rt - 1.55µm),波浪度参数显著增加(Wa 0.25µm, Wt 4.02µm)。扫描电镜评价显示,完整的IPR序列进行IPR时,表面更加光滑和规则。单金属条确定了更多不规则的表面,其特征是延伸的凹槽,与珐琅脊和不规则碎片交替。结论:采用标准的IPR振荡序列可以在手术结束时确定更规则和和谐的牙釉质表面。IPR后适当的抛光对于保证良好的长期预后和良好的生物结构方面起着至关重要的作用。
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引用次数: 0
Comparison of the effects of different rapid maxillary expansion techniques on craniofacial structures: a finite element analysis study. 不同上颌快速扩张技术对颅面结构影响的比较:有限元分析研究。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-03-06 DOI: 10.1186/s40510-023-00459-2
Nihal Kaya, Elif Dilara Seker, Türker Yücesoy

Aim: To compare the effects of three different maxillary expansion appliances with five different types of expansion modalities on stress distribution and displacement on the maxilla and its adjacent craniofacial structures using the finite element method (FEM).

Materials and methods: Cone-beam computed tomography data of a patient with maxillary transverse deficiency were rendered into a three-dimensional model of craniomaxillary structures. The expansion appliances included tooth-borne, hybrid, and bone-borne expanders. Five different expansion modalities were applied to each expander [conventional Rapid Maxillary Expansion (RME) (type 1), midpalatal suture cortico-puncture-assisted RME (type 2), LeFort l cortico-puncture-assisted RME (type 3), surgically assisted RME (SARME) without pterygomaxillary junction (PMJ) separation (type 4), and SARME with bilateral PMJ separation (type 5)]. The numerical and visual data were analyzed.

Results: The highest amount of stress accumulation on teeth was found in the tooth-borne and hybrid groups. On the other hand, more stress concentration on the maxilla was observed in the bone-borne group. SARME cuts with PMJ separation increased total movement by reducing the stress on the midpalatal suture in all groups. While types 1, 2, and 3 were similar in terms of the amounts of displacement, types 4 and 5 increased the total amount of displacement in all groups. The total amounts of displacements from the highest value to the lowest value for the anterior and posterior maxilla were in the bone-borne, tooth-borne, and hybrid groups.

Conclusions: SARME cuts were effective in reducing stress on the teeth, but the cortico-puncture application affected neither the stress values on the teeth nor the transverse displacement in the tooth-borne expanders. Surgical procedures such as SARME and corticotomy should be used with bone-borne devices to improve the outcomes of maxillary expansion procedures.

目的:采用有限元法比较3种不同上颌扩展器、5种不同扩展方式对上颌及其邻近颅面结构应力分布和位移的影响。材料与方法:将1例上颌横断缺损患者的锥束计算机断层数据绘制成三维颅颌结构模型。扩展器具包括牙载、混合型和骨载扩展器。每个扩张器采用五种不同的扩张方式[常规快速上颌扩张(RME)(1型),中腭缝合皮质穿刺辅助RME(2型),LeFort 1皮质穿刺辅助RME(3型),手术辅助RME (SARME)不分离翼颌交界处(PMJ)(4型)和双侧PMJ分离的SARME(5型)]。对数值和视觉数据进行了分析。结果:牙源性组和杂交组牙体应力积累量最大。另一方面,骨载组在上颌骨上观察到更多的应力集中。在所有组中,经PMJ分离的SARME切口通过减少对中腭缝线的压力而增加了总运动。类型1、2和3的位移量相似,而类型4和5在所有组中都增加了总位移量。前、后上颌移位总量由最大值到最小值依次为骨载组、牙载组和杂交组。结论:SARME切口能有效降低牙体应力,但皮质穿刺不影响牙体应力值,也不影响牙体扩张器的横向位移。外科手术如SARME和皮质切开术应与骨载装置一起使用,以改善上颌扩张手术的结果。
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引用次数: 1
Stress distribution and displacement in the maxillofacial complex during intrusion and distalization of the maxillary arch using miniplates versus mini-implants: a 3-dimensional finite element study. 微型钢板与微型种植体在上颌弓内伸和外伸过程中颌面复合体的应力分布和位移:三维有限元研究
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-03-01 DOI: 10.1186/s40510-023-00455-6
Abinaya Somaskandhan, N M Vijay Kumar, R Devaki Vijayalakshmi

Objectives: To three-dimensionally analyse the stress distribution and displacement pattern in the maxillofacial complex following intrusion and distalization of the maxillary arch using finite element analysis in skeletal class II malocclusion with prognathic maxilla and vertical maxillary excess using miniplates and mini-implants.

Materials and methods: Finite Element models of a skull, Y-shaped stainless steel miniplate, mini-implant and a posted arch were generated. Three force levels (1) 200 g (2) 300 g and (3) 500 g per side were applied to the assembly. The models were pre-processed and the analysis was performed using ANSYS version 18.1 software. Alterations in von mises stress, principal maximum stress, principal minimum stress and compressive stress were analysed around the sutures and surface landmarks.

Results: With miniplates, there was a maximum stress concentration at the zygomatic buttress with even stress distribution at the fronto-maxillary, zygomatico-temporal, zygomatico-frontal and pterygomaxillary sutures along with anatomical landmarks such as frontal process of maxilla, ANS, Point A, prosthion and maxillary process of zygoma. First molars experienced greater distalization effects with buccal flaring when miniplates were used. With mini-implants, canine and premolars also exhibited greater distalization effects. In the root apices, lateral incisors showed increased lingual root movement with mini-implants.

Conclusion: Miniplates provide a greater distalizing effect while mini-implants produce increased intrusive effect. The distalizing effect is greater when 500 g of force is applied using miniplates with significantly even stress distribution and displacement pattern.

目的:应用有限元分析方法,对颌骨ⅱ类错颌前颌和垂直上颌过度患者应用微型钢板和微型种植体进行上颌弓突突和远突后颌面复合体的应力分布和位移模式进行三维分析。材料与方法:制作颅骨、y形不锈钢微型钢板、微型种植体和立柱弓的有限元模型。组件每侧施加三个力水平(1)200g (2) 300g和(3)500g。采用ANSYS 18.1版软件对模型进行预处理和分析。在缝合处和表面标志处分析von mises应力、主最大应力、主最小应力和压应力的变化。结果:微型钢板在颧支撑处应力集中最大,在前颌缝、颧颞缝、颧额缝、翼颌缝处应力分布均匀,且在上颌骨额突、ANS、a点、假体、颧突等解剖标志处应力分布均匀。第一磨牙在使用微型牙板时,有较好的远端效果。使用微型种植体,犬齿和前磨牙也表现出更大的远端效果。在根尖,侧切牙显示增加舌根运动与微型种植体。结论:小型钢板具有较好的离体效果,而小型种植体具有较强的侵入性。当使用应力分布和位移模式明显均匀的微型板施加500g力时,远距效果更大。
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引用次数: 1
A quantitative three-dimensional comparative study of alveolar bone changes and apical root resorption between clear aligners and fixed orthodontic appliances. 透明矫正器与固定矫治器牙槽骨变化及根尖吸收的定量三维比较研究。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-02-27 DOI: 10.1186/s40510-023-00458-3
Ibtehal Almagrami, Abeer A Almashraqi, Bushra Sufyan Almaqrami, Amin S Mohamed, Khaled Wafaie, Maher Al-Balaa, Yiqiang Qiao

Background: This study aimed to evaluate and compare the alveolar bone changes and to investigate the prevalence and severity of orthodontically induced inflammatory root resorption (OIIRR) of maxillary incisors in patients who received treatment with clear aligners (CA) versus conventional fixed appliances (FA), using cone-beam computed tomography (CBCT).

Methods: One hundred sixty maxillary incisors from 40 patients with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores were divided into the CA and FA groups. The dentoalveolar quantitative changes were analyzed using pre- (T0) and post-treatment (T1) CBCT. The measured parameters included alveolar bone thickness (ABT), alveolar bone height (ABH), root length (OIIRR), and maxillary incisor inclinations.

Results: Post-treatment, the average palatal and total ABT significantly decreased in central and lateral incisors in the FA group. In contrast, the CA group's average labial ABT of the lateral incisors decreased considerably. Regarding the ABH, both groups showed significant labial and palatal marginal bone resorption. In both groups, root lengths significantly decreased after treatment (p < 0.005). The inter-group comparison revealed that ABT and root length had significantly decreased in the FA group compared to the CA group, while the ABH showed no significant difference between the two groups. The mean absolute reductions of ABT and OIIRR in the CA group were significantly less (- 0.01 ± 0.89 and 0.31 ± 0.42) than those in the FA group (0.20 ± 0.82 and 0.68 ± 0.97), respectively.

Conclusions: CA and FA treatments appear to cause a significant ABT reduction and a statistically significant increased OIIRR in the maxillary incisor region, with a greater extent expected with FA treatment. However, the increased OIIRR values in the majority of both groups' cases were not clinically significant. Both treatment modalities resulted in a significant ABH reduction, with the highest found in the labial side of lateral incisors in the CA group.

背景:本研究旨在通过锥形束计算机断层扫描(CBCT)评估和比较接受透明矫正器(CA)和传统固定矫治器(FA)治疗的上颌门牙正畸诱导的炎症性牙根吸收(OIIRR)的患病率和严重程度。方法:选取基线特征相似的40例患者160颗上颌切牙,根据美国正畸委员会差异指数评分分为CA组和FA组。采用治疗前(T0)和治疗后(T1) CBCT分析牙槽牙的定量变化。测量参数包括牙槽骨厚度(ABT)、牙槽骨高度(ABH)、牙根长度(OIIRR)和上颌切牙倾斜度。结果:FA组治疗后中、侧切牙平均腭ABT和总ABT均显著降低。相比之下,CA组侧切牙的平均唇侧ABT明显下降。在ABH方面,两组均表现出明显的唇缘和腭缘骨吸收。两组患者治疗后根长均显著减少(p)。结论:CA和FA治疗明显降低了上颌切牙区域的ABT,统计学上显著增加了上颌切牙区域的OIIRR, FA治疗的预期效果更大。然而,两组病例中大多数病例的OIIRR值升高没有临床意义。两种治疗方式均可显著减少ABH, CA组侧切牙唇侧ABH减少最多。
{"title":"A quantitative three-dimensional comparative study of alveolar bone changes and apical root resorption between clear aligners and fixed orthodontic appliances.","authors":"Ibtehal Almagrami,&nbsp;Abeer A Almashraqi,&nbsp;Bushra Sufyan Almaqrami,&nbsp;Amin S Mohamed,&nbsp;Khaled Wafaie,&nbsp;Maher Al-Balaa,&nbsp;Yiqiang Qiao","doi":"10.1186/s40510-023-00458-3","DOIUrl":"https://doi.org/10.1186/s40510-023-00458-3","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate and compare the alveolar bone changes and to investigate the prevalence and severity of orthodontically induced inflammatory root resorption (OIIRR) of maxillary incisors in patients who received treatment with clear aligners (CA) versus conventional fixed appliances (FA), using cone-beam computed tomography (CBCT).</p><p><strong>Methods: </strong>One hundred sixty maxillary incisors from 40 patients with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores were divided into the CA and FA groups. The dentoalveolar quantitative changes were analyzed using pre- (T0) and post-treatment (T1) CBCT. The measured parameters included alveolar bone thickness (ABT), alveolar bone height (ABH), root length (OIIRR), and maxillary incisor inclinations.</p><p><strong>Results: </strong>Post-treatment, the average palatal and total ABT significantly decreased in central and lateral incisors in the FA group. In contrast, the CA group's average labial ABT of the lateral incisors decreased considerably. Regarding the ABH, both groups showed significant labial and palatal marginal bone resorption. In both groups, root lengths significantly decreased after treatment (p < 0.005). The inter-group comparison revealed that ABT and root length had significantly decreased in the FA group compared to the CA group, while the ABH showed no significant difference between the two groups. The mean absolute reductions of ABT and OIIRR in the CA group were significantly less (- 0.01 ± 0.89 and 0.31 ± 0.42) than those in the FA group (0.20 ± 0.82 and 0.68 ± 0.97), respectively.</p><p><strong>Conclusions: </strong>CA and FA treatments appear to cause a significant ABT reduction and a statistically significant increased OIIRR in the maxillary incisor region, with a greater extent expected with FA treatment. However, the increased OIIRR values in the majority of both groups' cases were not clinically significant. Both treatment modalities resulted in a significant ABH reduction, with the highest found in the labial side of lateral incisors in the CA group.</p>","PeriodicalId":56071,"journal":{"name":"Progress in Orthodontics","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Stress and movement trend of lower incisors with different IMPA intruded by clear aligner: a three-dimensional finite element analysis. 不同IMPA下门牙被清晰矫正器侵入的应力和运动趋势:三维有限元分析。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-02-13 DOI: 10.1186/s40510-023-00454-7
Yixin Li, Shengzhao Xiao, Yu Jin, Cheng Zhu, Ruomei Li, Yikan Zheng, Rongjing Chen, Lunguo Xia, Bing Fang

Background: During the intrusion of lower incisors with clear aligners (CAs), root disengagement from the alveolar bone often occurs, resulting in serious complications. This study aimed to determine the potential force mechanism of the mandibular anterior teeth under the pressure of CA, providing theoretical data for clinical practice.

Methods: In this study, a 3D finite element model was established, including the CA, periodontal ligament, and mandibular dentition. Incisor mandibular plane angles were set as 5 groups: 90°, 95°, 100°, 105°, and 110°. The 4 mandibular incisors were intruded by 0.2 mm, while the canines were the anchorage teeth. The stress, force systems, and potential movement trends of mandibular anterior teeth were obtained.

Results: The compressive stress of the incisors was concentrated in the lingual fossa, incisal ridge, and apex. With the increase in IMPA, the moment of central incisors changed from lingual crown moment to labial crown moment, with the turning point between 100° and 105°, but the center of resistance (CR) was always subjected to the force toward the lingual and intrusive direction. The force and moment toward the labial side of the lateral incisors were greater than those toward the central incisors. The canines always tipped distally and received extrusive force with no relationship with IMPA.

Conclusions: With the increase in the initial IMPA, the direction of labiolingual force on the mandibular incisors was reversed. However, the root of the lower incisors always tipped labially, which indicated fenestration and dehiscence.

背景:下门牙植入牙槽骨矫正器(ca)时,经常发生牙根与牙槽骨脱离,导致严重的并发症。本研究旨在探讨下颌前牙在CA压力下的潜在受力机制,为临床实践提供理论依据。方法:建立CA、牙周韧带、下颌牙列三维有限元模型。切下颌平面角设为90°、95°、100°、105°、110°5组。4个下切牙内嵌0.2 mm,犬齿为支抗牙。获得了下颌前牙的应力、受力系统和潜在的运动趋势。结果:切牙的压应力主要集中在舌窝、切脊和牙尖。随着IMPA的增加,中切牙的弯矩由舌冠弯矩转变为唇冠弯矩,弯矩在100°~ 105°之间,但阻力中心(CR)始终受到向舌突方向的作用力。侧切牙朝向唇侧的力和力矩大于中切牙朝向唇侧的力和力矩。犬齿总是向远端倾斜并受到挤压力,与IMPA无关。结论:随着初始内压的增加,下切牙唇舌受力方向发生逆转。但下门牙的牙根总是向唇尖倾斜,这表明开窗和开裂。
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引用次数: 3
The effect of orthodontic treatment on smile attractiveness: a systematic review. 正畸治疗对微笑吸引力的影响:系统性综述。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-02-06 DOI: 10.1186/s40510-023-00456-5
G Coppola, I Christopoulou, N Gkantidis, C Verna, N Pandis, G Kanavakis

Background: Smile attractiveness is a primary factor for patients to seek orthodontic treatment, however, there is yet no systematic evaluation of this topic in the literature.

Objectives: To assess the current evidence on the effect of orthodontic treatment on smile attractiveness.

Search methods: Seven electronic databases (MEDLINE, Cochrane Library, Virtual Health Library, SCOPUS, Web of Science, Google Scholar and Embase) were searched on 14 September 2022.

Selection criteria: Studies evaluating smile attractiveness before and after orthodontic treatment or only after completion of orthodontic treatment.

Data collection and analysis: Extracted data included study design and setting, sample size and demographics, malocclusion type, treatment modality and method for outcome assessment. Risk of bias was assessed with the ROBINS-I tool for non-randomised studies. Random-effects meta-analyses of mean differences and their 95% confidence intervals (CIs) were planned a priori.

Methods: After elimination of duplicate studies, data extraction and risk of bias assessment according to the Cochrane guidelines, an evaluation of the overall evidence was performed. The included studies were evaluated based on the characteristics of their study and control groups and based on their main research question. Also, all outcome measures were standardized into a common assessment scale (0-100), in order to obtain more easily interpretable results.

Results: Ten studies were included in this review, nine of which were assessed as being at serious risk of bias and one at moderate risk of bias. The large heterogeneity between the included studies did not allow for a meta-analysis. Orthodontic treatment has a moderately positive effect on smile attractiveness. When compared to no treatment, orthodontic treatment with premolar extractions improves smile attractiveness by 22%. Also, surgical correction of Class III cases increases smile attractiveness by 7.5% more than camouflage treatment. No other significant differences were shown between different types of treatment.

Conclusion: Based on the available data, orthodontic treatment seems to moderately improve the attractiveness of the smile. There is significant bias in the current literature assessing the effect of orthodontics on smile attractiveness; therefore, the results cannot be accepted with certainty.

背景:微笑的吸引力是患者寻求正畸治疗的首要因素:微笑吸引力是患者寻求正畸治疗的首要因素,然而,目前尚无文献对这一主题进行系统评估:评估正畸治疗对微笑吸引力影响的现有证据:检索方法:于 2022 年 9 月 14 日检索了七个电子数据库(MEDLINE、Cochrane Library、Virtual Health Library、SCOPUS、Web of Science、Google Scholar 和 Embase):数据收集与分析:提取的数据包括研究设计和环境、样本量和人口统计学、错颌畸形类型、治疗方式和结果评估方法。采用ROBINS-I工具对非随机研究的偏倚风险进行评估。对平均差异及其 95% 置信区间(CIs)进行随机效应荟萃分析是事先计划好的:根据 Cochrane 指南剔除重复研究、提取数据并评估偏倚风险后,对总体证据进行评估。根据研究组和对照组的特点以及主要研究问题对纳入的研究进行了评估。此外,为了获得更易于解释的结果,还将所有结果测量标准化为一个通用的评估量表(0-100):本综述共纳入 10 项研究,其中 9 项被评估为存在严重偏倚风险,1 项存在中度偏倚风险。由于所纳入的研究之间存在较大的异质性,因此无法进行荟萃分析。正畸治疗对微笑的吸引力有适度的积极影响。与不进行治疗相比,拔除前磨牙的正畸治疗可将微笑吸引力提高 22%。此外,对 III 类病例进行手术矫正比伪装治疗可提高微笑吸引力 7.5%。不同类型的治疗之间没有其他明显差异:根据现有数据,正畸治疗似乎能适度提高微笑的吸引力。在评估正畸对微笑吸引力的影响方面,目前的文献存在很大的偏差;因此,不能肯定地接受这些结果。
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引用次数: 0
A retrospective comparison of two protocols for correction of skeletal Class III malocclusion in prepubertal children: hybrid hyrax expander with mandibular miniplates and rapid maxillary expansion with face mask. 两种矫正青春期前儿童骨骼III类错牙合的方案的回顾性比较:下颌微型板混合式hyrax扩弓器和面罩快速上颌扩弓器。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-01-23 DOI: 10.1186/s40510-022-00446-z
Nour Eldin Tarraf, Oyku Dalci, Kerem Dalci, Ayse Tuba Altug, M Ali Darendeliler

Background: This study compared the skeletal and dental effects of a hybrid maxillary expander with mandibular miniplates (HE-MP) and Class III elastics to conventional tooth-borne rapid maxillary expander and face mask (RME-FM) in skeletal Class III treatment.

Methods: This retrospective study included 36 skeletal Class III patients. Eighteen patients (mean age 10.24 ± 1.31 years) were treated with a hybrid expander, two mandibular L-shaped miniplates and full-time Class III elastics (HE-MP group). Their results were compared to a group of patients treated with conventional RME-FM (n = 18; mean age 10.56 ± 1.41 year). Radiographs were taken before (T1) and after treatment (T2). All patients were in cervical maturation stages CS1-CS3 at T1. The measured outcomes were the changes in sagittal and vertical skeletal and dental cephalometric measurements.

Results: Treatment time was approximately 15.5 ± 2.8 months with the HE-MP and 11.85 ± 3.41 months for the RME-FM. The Class III malocclusion was corrected in both groups with significant changes. The maxilla advanced more in the HE-MP group, with an increase in SNA of 4.26° ± 2.15° compared to 1.14 ± 0.93 in the RME-FM group (p < 0.001). The effect on the mandible was similar in both groups, while the overall skeletal change was significantly greater with HE-MP, with an increase in the ANB of 5.25° ± 2.03° and a Wits appraisal increase of 6.03 ± 3.13 mm, as opposed to 2.04° ± 1.07° and 2.94 ± 1.75 mm with the RME-FM (p < 0.001). Dental changes were significantly higher with RME-FM, with an increase in incisor inclination (U1-SN) of 5.02° ± 3.93° (p < 0.001), with no significant changes in the HE-MP group. The mandibular incisors retroclined by 5.29° ± 3.57° at L1-MP with the RME-FM, while they advanced slightly with the HE-MP by 2.87° ± 5.37° (p < 0.001).

Conclusion: The use of skeletal anchorage for maxillary expansion and protraction significantly increases skeletal effects and reduces dental side effects compared to tooth-borne maxillary expansion and protraction. These results need to be investigated in the long term.

背景:本研究比较了在骨骼III级治疗中,带有下颌微型钢板(HE-MP)和III级弹性体的混合上颌扩张器与传统的牙载快速上颌扩张机和面罩(RME-FM)的骨骼和牙齿效果。方法:本回顾性研究包括36例骨骼III级患者。18名患者(平均年龄10.24 ± 1.31岁)用混合扩张器、两块下颌L形微型钢板和全时III级弹性体(HE-MP组)进行治疗。他们的结果与一组接受常规RME-FM治疗的患者进行了比较(n = 18;平均年龄10.56 ± 1.41年)。在治疗前(T1)和治疗后(T2)拍摄射线照片。所有患者在T1时均处于宫颈成熟期CS1-CS3。测量的结果是矢状面和垂直骨骼和牙齿头影测量的变化。结果:治疗时间约为15.5 ± HE-MP 2.8个月,11.85 ± RME-FM 3.41个月。两组均矫正了III类错牙合,并有显著变化。HE-MP组上颌骨前移较多,SNA增加4.26° ± 2.15°,而1.14° ± RME-FM组0.93(p 结论:与牙源性上颌扩大和前伸相比,使用骨锚定进行上颌扩大和后伸可显著增加骨骼效果,减少牙齿副作用。这些结果需要长期研究。
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引用次数: 1
Predictability of orthodontic tooth movement with aligners: effect of treatment design. 矫正器矫正牙齿移动的可预测性:治疗设计的影响。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-01-16 DOI: 10.1186/s40510-022-00453-0
Tommaso Castroflorio, Ambra Sedran, Simone Parrini, Francesco Garino, Matteo Reverdito, Riccardo Capuozzo, Sabrina Mutinelli, Simonas Grybauskas, Mantas Vaitiekūnas, Andrea Deregibus

Backgrounds: The present study was designed to define: (1) which are the less predictable OTM with Invisalign aligners when the treatment plan is designed by expert operators, (2) if the presence and shape of attachments influence the predictability of OTM and (3) if patients' demographics influence OTM predictability. The sample comprises 79 prospectively recruited patients (mean age 30.8 years; SD 12.0; 23 M, 56 F), treated by expert operators with an average of 27 aligners (SD 15) in the maxillary arch and 25 aligners (SD 11) in the mandibular arch. Post-treatment digital models and final virtual treatment plan models were exported from ClinCheck® software as STL files and subsequently imported into Geomagic Qualify ®software, to compare final teeth positions. The differences were calculated and tested for statistical significance for each tooth in the mesial-distal, vestibular-lingual and occlusal-gingival directions, as well as for angulation, inclination and rotation. In addition, the statistical significance of categorical variables was tested.

Results: The lack of correction was significant for all movements and in all group of teeth (P < 0.01) except for the rotation of maxillary first molar. The prescribed OTM, the group of teeth and movement, the frequency of aligner change and the use of attachment influence the outcome. The greatest discrepancies in predicted and achieved tooth position were found for angular movements and rotation of teeth characterized by round-shaped crowns, for a ratio of approximately 0.4° per 1° prescribed. Optimized attachments for upper canines and lower premolar rotation seem not working properly. Second molar movements are mostly unexpressed. Furthermore, changing the aligner every 14 days will reduce the lack of correction of the 12% with respect to 7 days aligner change.

Conclusions: Predictability of orthodontic movement with aligners still has limitations related to the biomechanics of the system: the shape of some attachments and the characteristics of aligner material need to be redefined. However, the results of this study allow to properly design the virtual treatment plan, revealing how much overcorrection is needed and which attachments are most effective.

背景:本研究旨在定义:(1)当由专业操作员设计治疗计划时,Invisalign矫正器的哪些OTM是不太可预测的,(2)附件的存在和形状是否影响OTM的可预测性,以及(3)患者的人口统计学是否影响OTM的预测性。该样本包括79名前瞻性招募的患者(平均年龄30.8岁;标准差12.0;23 M,56 F),由专家操作员进行治疗,上颌弓平均使用27个矫正器(标准差15),下颌弓平均使用25个矫正器。从ClinCheck®软件导出治疗后数字模型和最终虚拟治疗计划模型作为STL文件,随后导入Geomagic Qualify®软件,以比较最终牙齿位置。计算并测试每颗牙齿在近中-远中、前庭-舌和咬合-牙龈方向上的差异,以及角度、倾斜和旋转的统计学意义。此外,还检验了分类变量的统计学显著性。结果:矫正缺失在所有运动和所有组牙中均有显著性差异(P 结论:使用矫正器进行正畸运动的可预测性仍然存在与系统生物力学相关的局限性:一些附件的形状和矫正器材料的特性需要重新定义。然而,这项研究的结果允许正确设计虚拟治疗计划,揭示需要多少过度矫正以及哪些附件最有效。
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引用次数: 14
IPR treatment and attachments design in clear aligner therapy and risk of open gingival embrasures in adults. 透明矫正器治疗中的IPR治疗和附着物设计与成人开放性牙龈囊膜的风险。
IF 4.8 2区 医学 Q1 Dentistry Pub Date : 2023-01-09 DOI: 10.1186/s40510-022-00452-1
Yubohan Zhang, Xu Wang, Jihong Wang, Jie Gao, Xulin Liu, Zuolin Jin, Yanning Ma

Background: The incidence of open gingival embrasures (OGE) in patients after fixed appliance treatment is relatively high, while there are no detailed reports on patients after clear aligner therapy. Also, no clinical studies with large sample size have investigated whether interproximal enamel reduction (IPR) can actually avoid OGE. The purpose of this study was to determine the prevalence of OGE in adults after clear aligner therapy and to investigate the risk of OGE associated with IPR treatment and attachment design, focusing on the amount and distribution in mandibular anterior teeth.

Methods: Pre-treatment and post-treatment intraoral frontal photographs of 225 non-extraction patients were evaluated retrospectively for the occurrence and severity of OGE. The amount of IPR and the number of attachments in the anterior teeth from subjects after screening were recorded according to the first version of clear aligner software (Clincheck, San Jose, USA) and clinical medical documents. Logistic regression analysis was performed to identify the factors contributing to OGE.

Results: The incidence of OGE in non-extraction patients after clear therapy between maxillary and mandibular central incisors was 25.7% and 40.3%, respectively. IPR was not associated with the occurrence of OGE but was associated with severity (P < 0.05). The number of attachments in the anterior teeth or central incisors was significantly related to the incidence of OGE (P < 0.05) but was not associated with severity.

Conclusion: A high rate of OGE occurs after clear aligner therapy. Clinicians should be aware of the application of IPR and the design of attachments during clear aligner therapy.

背景:固定矫治器治疗后患者出现开放性龈囊(OGE)的发生率较高,而透明矫正器治疗后患者的相关报道尚未见详细报道。此外,尚无大样本量的临床研究调查近端间牙釉质还原(IPR)是否真的可以避免OGE。本研究的目的是确定清除矫正器治疗后成人OGE的患病率,并调查与IPR治疗和附着体设计相关的OGE风险,重点关注下颌前牙的数量和分布。方法:回顾性分析225例未拔牙患者治疗前后的口内正面照片,分析其发生及严重程度。根据Clincheck, San Jose, USA第一版clear aligner软件和临床医学文献记录筛选后受试者前牙的IPR数量和附着体数量。采用Logistic回归分析确定影响OGE的因素。结果:未拔牙患者上颌中切牙间清除治疗后OGE发生率分别为25.7%和40.3%。IPR与OGE的发生无相关性,但与严重程度相关(P)结论:清除矫正器治疗后OGE发生率高。临床医生应该意识到IPR的应用和清晰对准器治疗期间附着物的设计。
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引用次数: 4
期刊
Progress in Orthodontics
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